1.1.1 Antacids and simeticone

ChoiceDrugDosagePresentation
1st choiceCo-magaldrox 195/220 (Mucogel® suspension)Dose: 10-20ml three times daily, 20-60 minutes after meals, and at bedtime or when required

Sugar-free, low Na+

Pack Size: 500ml

Prescribing Notes

  • Refer to NICE clinical guideline on dyspepsia and gastro‑oesophageal reflux disease (2014) here.
  • Particular care is required in patients presenting with ‘alarm features’.
  • Multi-ingredient GI preparations such as Peptac® should not be prescribed generically.
  • Antacids are best given when symptoms occur or are expected, usually between meals and at bedtime.
  • Antacids should preferably not be taken at the same time as other drugs since they may impair absorption and can damage enteric coatings designed to prevent dissolution in the stomach.
  • Use a low sodium content preparation for patients suffering from hypertension or heart failure, e.g. co-magaldrox.
  • Compound alginic acid preparations are less powerful antacids than co-magaldrox but may be more effective for heartburn. They are significantly more expensive than simple antacids.
  • Antacids may be useful to be taken as required when patients are stepping down or stopping treatment with long-term PPI/acid suppression therapy.